Clinicians caring for poisoned pediatric patients should develop a level of clinical competence and factual comfort in this area to optimize assessment, stabilization, and ultimately patient outcome. This article focuses on clinically relevant considerations specific to poisoned pediatric patients. Special emphasis is given to unique physical examination findings and nuances, appropriateness of the various gastrointestinal decontamination techniques, and management of toxins that commonly result in severe, life-threatening toxicity in children. Last, case samples are provided for those toxins that are dangerous to children in small doses or those that act differently in children after overdose.